{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T02:52:07Z","timestamp":1790823127446,"version":"4.1.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,5,15]],"date-time":"2021-05-15T00:00:00Z","timestamp":1621036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010414","name":"Health Research Board","doi-asserted-by":"publisher","award":["ECSA-2020-05"],"award-info":[{"award-number":["ECSA-2020-05"]}],"id":[{"id":"10.13039\/100010414","id-type":"DOI","asserted-by":"publisher"}]},{"name":"St John of God Research Foundation"},{"DOI":"10.13039\/501100002341","name":"Academy of Finland","doi-asserted-by":"publisher","award":["297598"],"award-info":[{"award-number":["297598"]}],"id":[{"id":"10.13039\/501100002341","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002341","name":"Academy of Finland","doi-asserted-by":"publisher","award":["288960"],"award-info":[{"award-number":["288960"]}],"id":[{"id":"10.13039\/501100002341","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Flagship Programme","award":["320162"],"award-info":[{"award-number":["320162"]}]},{"name":"Health from Cohorts and Biobanks Programme","award":["308552"],"award-info":[{"award-number":["308552"]}]},{"name":"Strategic Academic Recruitment"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Expanding clinical strategies to identify high risk groups for psychotic and bipolar disorders is a research priority. Considering that individuals diagnosed with psychotic and bipolar disorder are at high risk of self-harm, we hypothesised the reverse order relationship would also be true (ie, self-harm would predict psychotic\/bipolar disorder). Specifically, we hypothesised that hospital presentation for self-harm would be a marker of high risk for subsequent development of psychotic\/bipolar disorder and sought to test this hypothesis in a large population sample. This prospective register-based study included everyone born in Finland in 1987, followed until age 28 years (N = 59 476). We identified all hospital records of self-harm presentations, as well as all ICD-10 healthcare registrations of first diagnoses of psychotic and bipolar disorders. Cox proportional hazards models were used to assess the relationship between self-harm and psychotic\/bipolar disorders. Of all individuals who presented to hospital with self-harm (n = 481), 12.8% went on to receive a diagnosis of psychosis (hazard ratio [HR] = 6.03, 95% confidence interval [CI] 4.56\u20137.98) and 9.4% a diagnosis of bipolar disorder (HR = 7.85, 95% CI 5.73\u201310.76) by age 28 years. Younger age of first self-harm presentation was associated with higher risk\u2014for individuals who presented before age 18 years, 29.1% developed a psychotic or bipolar disorder by age 28 years. Young people who present to hospital with self-harm are at high risk of future psychotic and bipolar disorders. They represent an important cohort for the prevention of serious mental illness.<\/jats:p>","DOI":"10.1093\/schbul\/sbab061","type":"journal-article","created":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T11:32:20Z","timestamp":1618831940000},"page":"1685-1694","source":"Crossref","is-referenced-by-count":35,"title":["Hospital Presentation for Self-Harm in Youth as a Risk Marker for Later Psychotic and Bipolar Disorders: A Cohort Study of 59 476 Finns"],"prefix":"10.1093","volume":"47","author":[{"given":"Koen","family":"Bolhuis","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland"},{"name":"Department of Child and Adolescent Psychiatry, Erasmus Medical Centre-Sophia Children\u2019s Hospital, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulla","family":"L\u00e5ng","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Royal College of Surgeons 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Hospital, Oulu, Finland"},{"name":"Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8254-7525","authenticated-orcid":false,"given":"Mika","family":"Gissler","sequence":"additional","affiliation":[{"name":"Department of Child Psychiatry and INVEST Research Flagship Center, University of Turku and Turku University Hospital, Turku, Finland"},{"name":"Finnish Institute for Health and Welfare, Helsinki, Finland"},{"name":"Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Kelleher","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland"},{"name":"Lucena Clinic Child and Adolescent Mental Health Service, Rathgar, 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